Elite Hospitals Plunge Into Unproven Stem Cell Treatments

Elite Hospitals Plunge Into Unproven Stem Cell Treatments – By Liz Szabo – Apr 2019

The online video seems to promise everything an arthritis patient could want. Dr. Adam Pourcho extols the benefits of stem cells and “regenerative medicine” for healing joints without surgery.

It sickens me when some doctors go rogue like this – especially when it involves money and pain. That combination is the perfect engine for profit in our medical system:

• medical procedures can cost as much as the “market” can bear and
• the “market” consists of desperate pain patients who are no longer allowed their previously effective medications

In their suicidal desperation, these patients will agree to pay almost any amount to get relief from their unrelenting pain. 

If the doctor were touting a method that cost only $20, $200, or even $2000, he would be far more believable. But when it takes multiple treatments of several thousand dollars each, this points to profiteering.

The video’s cheerleading tone mimics the infomercials used to promote stem cell clinics, several of which have recently gotten into hot water with federal regulators

It was sponsored by Swedish Medical Center, the largest nonprofit health provider in the Seattle area.

And then legitimate medical groups can’t resist the profits either.

Swedish is one of a growing number of respected hospitals and health systems — including the Mayo Clinic, the Cleveland Clinic and the University of Miami — that have entered the lucrative business of stem cells and related therapies, including platelet injections

Typical treatments involve injecting patients’ joints with their own fat or bone marrow cells, or with extracts of platelets, the cell fragments known for their role in clotting blood.

Many patients seek out regenerative medicine to stave off surgery, even though the evidence supporting these experimental therapies is thin at best, Knoepfler said.

‘Expensive Placebos’

While hospital-based stem cell treatments may be legal, there’s no strong evidence they work, said Leigh Turner, an associate professor at the University of Minnesota’s Center for Bioethics who has published a series of articles describing the size and dynamics of the stem cell market. 

For doctors and hospitals, stem cells are easy money.

Lately, it seems that even in medicine, money has become the most important measure for healthcare.

Turner said. Patients typically pay more than $700 a treatment for platelets and up to $5,000 for fat and bone marrow injections

As a bonus, doctors don’t have to wrangle with insurance companies, which view the procedures asexperimental and largely don’t cover them.

“It’s lucrative. It’s easy to do. All these reputable institutions, they don’t want to miss out on the business,” said Dr. James Rickert

Knoepfler said the guests on the video make several “unbelievable” claims.

At one point, Dr. Pourcho says that platelets release growth factors that tell the brain which types of stem cells to send to the site of an injury.

This is a blatantly fabricated and completely impossible “explanation”.

Despite all the discouraging reports of doctors simply doing the bidding of their bosses (instead of practicing medicine), I’m still shocked by a doctor who so openly lies and makes statements that are biologically impossible. (Isn’t this the kind of issue the AMA should be looking at? Or do they no longer care about their reputation?)

This is just another sad demonstration of how the pursuit of money influences (corrupts) medicine these days.

Knoepfler, who has studied stem cell biology for two decades, said he has never heard of “any possibility of growing eyeball or other random tissues in your hand.”

Increasing Scrutiny

With more than 700 stem cell clinics in operation, the FDA is first targeting those posing the biggest threat, such as doctors who inject stem cells directly into the eye or brain.

“There are clearly bad actors who are well over the line and who are creating significant risks for patients,” Gottlieb said.

Gottlieb, set to leave office April 5, said he’s also concerned about the financial exploitation of patients in pain.

Well, now that we’re not being allowed pain relief from opioids, there’s a huge cohort of patients desperate for relief. And, because most of the silly alternatives suggested don’t help all that much, people consent to ever more dangerous and expensive treatments.

What exactly did they expect when they unleashed the vicious pain of potentially millions of people?

there is a broad “spectrum” of stem cell providers, ranging from university scientists leading rigorous clinical trialsto doctors who promise stem cells are “for just about anything.” Hospitals operate somewhere in the middle, Marks said.

The market for arthritis treatment is huge and growing. At least 30 million Americans have the most common form of arthritis, with diagnoses expected to soar as the population ages. Platelet injections for arthritis generated more than $93 million in revenue in 2015, according to an article last year in The Journal of Knee Surgery.

Lots Of Hype, Little Proof

Although some hospitals boast of high success rates for their stem cell procedures, published research often paints a different story.

PRP, or “platelet-rich plasma” injections.

In a 2013 paper, researchers described the cases of three patients whose pain got dramatically worse after PRP injections. One patient lost bone and underwent surgery to repair the damage.

Tests of other stem cell injections also have failed to live up to expectations.

A 2016 review in the Journal of Bone and Joint Surgery concluded that “the value and effective use of cell therapy in orthopaedics remain unclear.” The following year, a review in the British Journal of Sports Medicine concluded, “We do not recommend stem cell therapy” for knee arthritis.”

Orthopedists — surgeons who specialize in bones and muscles — have a history of performing unproven procedures, including spinal fusion, surgery for rotator cuff disease and arthroscopy for worn-out knees, Turner said. Recently, studies have shown them to be no more effective than placebos.

Misleading Marketing

Some argue that joint injections shouldn’t be marketed as stem cell treatments at all.

Patients are attracted to regenerative medicine because they assume it will regrow their lost cartilag

Although doctors hope that platelets will release anti-inflammatory substances, which could theoretically help calm an inflamed joint, they don’t know why some patients who receive platelet injections feel better, but others don’t.

That’s a new one to me: doctors giving a patient a treatment that they “hope” will work (despite a lack of evidence) instead of a less expensive, less invasive treatment that we know works (opioids).

Florida resident Kathy Walsh, 61, said she wasted nearly $10,000 on stem cell and platelet injections at a Miami clinic, hoping to avoid knee replacement surgery.

Eventually, she had both knees replaced. She has been nearly pain-free ever since. “My only regret,” she said, “is that I wasted so much time and money.”

Sometimes, the right surgery can miraculously fix the cause of pain.

The injections eased her pain for only a few months.

Liz Szabo: lszabo@kff.org, @LizSzabo